Active NPI
Jennifer M Wilson, MD
- Psychiatry Physician
- Indianapolis, IN
National Provider Identifier
1720017221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 01057724A
- Practice address
- 8401 Harcourt Rd
Indianapolis, IN 46260-2036 - Phone
- (317) 338-4850
- NPI assigned
- Jun 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 01057724A | IN | Primary |
Addresses
Primary practice location
8401 Harcourt Rd
Indianapolis, IN 46260-2036
Mailing address
8401 Harcourt Rd
Indianapolis, IN 46260-2036
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200822730 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01057724A | IN | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana University Psychiatric Associates, Inc. | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatry Physician
- Indianapolis, IN
- NPI 1023063724
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681862400000",
"number": "1720017221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8401 HARCOURT RD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462602036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8401 HARCOURT RD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462602036",
"telephone_number": "317-338-4850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JENNIFER",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2023-04-19",
"certification_date": "2023-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "01057724A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200822730",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.